- Paperback: 288 pages
- Publisher: Picador; 1st edition (January 22, 2008)
- Language: English
- ISBN-10: 0312427654
- ISBN-13: 978-0312427658
- Product Dimensions: 5.9 x 0.8 x 8.2 inches
- Shipping Weight: 9.6 ounces (View shipping rates and policies)
- Average Customer Review: 4.7 out of 5 stars See all reviews (376 customer reviews)
- Amazon Best Sellers Rank: #6,651 in Books (See Top 100 in Books)
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Better: A Surgeon's Notes on Performance 1st Edition
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From Publishers Weekly
Starred Review. Surgeon and MacArthur fellow Gawande applies his gift for dulcet prose to medical and ethical dilemmas in this collection of 12 original and previously published essays adapted from the New England Journal of Medicine and the New Yorker. If his 2002 collection, Complications, addressed the unfathomable intractability of the body, this is largely about how we erect barriers to seamless and thorough care. Doctors know they should wash their hands more often to avoid bacterial transfer in the ward, but once a minute does seem extreme. Using chaperones for breast exams seems a fine idea, but it does make situations awkward. "The social dimension turns out to be as essential as the scientific," Gawande writes—a conclusion that could serve as a thumbnail summary of his entire output. The heart of the book are the chapters "What Doctors Owe," about the U.S.'s blinkered malpractice system, and "Piecework," about what doctors earn. Cheerier, paradoxically, are the chapters involving polio and cystic fibrosis, featuring Dr. Pankaj Bhatnagar and Dr. Warren Warwick, two remarkable men who have been able to catapult their humanity into their work rather than constantly stumble over it. Indeed, one suspects that once we cure the ills of the health care system, we'll look back and see that Gawande's writings were part of the story. (Apr.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.
From Bookmarks Magazine
A surgeon at the Brigham and Women's Hospital in Boston and an assistant professor at the Harvard School of Public Health, Dr. Atul Gawande succeeds in putting a human face on controversial topics like malpractice and global disparities in medical care, while taking an unflinching look at his own failings as a doctor. Critics appreciated his candor, his sly sense of humor, and his skill in examining difficult issues from many perspectives. He conveys his messagethat doctors are only human and therefore must always be diligent and resourceful in fulfilling their dutiesin clear, confident prose. Most critics' only complaint was that half of the essays are reprints of earlier articles. Gawande's arguments, by turns inspiring and unsettling, may cause you to see your own doctor in a whole new light.
Copyright © 2004 Phillips & Nelson Media, Inc. --This text refers to an out of print or unavailable edition of this title.
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Top Customer Reviews
achieving handwashing by healthcare workers to reduce the spread of infections,
attempts to erradicate polio in India by chasing hotspots,
reducing mortality in the Iraq/Afghanistan wars by new strategies of battlefield care,
aspects of chaperones for intimate physical examinations,
different systems for physician compensation,
ways to reform our malpractice laws,
the inhumaness of execution methods and the ethics that prevent physicians from participating,
development of Apgar scores and how they have reduced newborn mortality,
and examples of how doctors and facilities that are highly specialized show better outcomes.
The author explores how significant innovations have been made by those who investigate new approaches and are committed to improvement and how we should all strive to make improvements within our personal niche in healthcare. "How to Become a Positive Deviant"
Dr. Atul Gawande has written prolifically on public health matters. He has participated in presidential campaigns and served in research and advisory capacities in the political arena. He is an expert on removing cancerous endocrine glands. I think anybody would only gain from reading Better, even if some essays appear to intentionally leave a few unanswered questions.
For me, the essay on washing hands stands out most, probably because it's an easy one to relate to any type of endeavor. Diligence matters, even when lives aren't on the line. This is one of the essays publically available online. Anybody can see how crazy it would be to have all medical staff thoroughly wash their hands for what would amount to a third of their workday. The solution to this problem turned out to be use of the alcohol gel, but results are only great if at least near total compliance is achieved.
Gawande addresses the issue of how one can really matter. This is relevant to almost all of us. The work we do has a profound impact on the people directly affected. Yet it's in our nature to want to matter in a much wider sense. Gawande looks for meaning in the context of being a doctor. The way he does it seems applicable to every type of work.
Even though you can find some of these essays free online, I think it's worth getting the book. I didn't find that any one essay led to another, that this was a very consistent body of thought. Others will disagree on that point. However, I've read some of the essays more than once. The complexity of thought and expression in Better call for this type of reading. I recommend this book for providing information about doctors' performance in the real world as well as its applicability to all of us.